Organization
BEHAVIORAL GUIDANCE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORRY A. SWAYZE (BILLING MGR.)
(316) 944-3940
Entity
Organization
Contact information
Practice address
400 N WOODLAWN ST STE 30, WICHITA, KS 67208-4333
(316) 944-3940
(316) 946-0694
Mailing address
PO BOX 17053, WICHITA, KS 67217-0053
(316) 944-3940
(316) 946-0694
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
3789
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200877570A
—
KS
01
—
3789
LICENSE
KS
01
—
KA2805013
MEDICARE #
KS
Enumeration date
12/08/2015
Last updated
01/04/2016
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